Compressible cannula connector with release grip

ABSTRACT

A tracheal tube assembly includes an outer cannula configured to be positioned in a patient airway and an inner cannula configured to be disposed inside the outer cannula. The tracheal tube assembly further includes a flange member secured about the outer cannula, and an outer cannula connector coupled to a proximal end of the outer cannula. The outer cannula connector includes a compressible portion may be compressed while inserting or removing the inner cannula.

BACKGROUND

The present disclosure relates generally to the field of tracheal tubesand, more particularly, to a tracheal tube including a compressibleouter cannula with a release grip.

This section is intended to introduce the reader to various aspects ofart that may be related to various aspects of the present disclosure,which are described and/or claimed below. This discussion is believed tobe helpful in providing the reader with background information tofacilitate a better understanding of the various aspects of the presentdisclosure. Accordingly, it should be understood that these statementsare to be read in this light, and not as admissions of prior art.

A wide variety of situations exist in which artificial ventilation of apatient may be desired. For short-term ventilation or during certainsurgical procedures, endotracheal tubes may be inserted through themouth to provide oxygen and other gasses to a patient. For otherapplications, particularly when longer-term intubation is anticipated,tracheostomy tubes may be preferred. Tracheostomy tubes are typicallyinserted through an incision made in the neck of the patient and throughthe trachea. A resulting stoma is formed between the tracheal ringsbelow the vocal chords. The tracheostomy tube is then inserted throughthe opening. In general, two procedures are common for insertion oftracheostomy tubes, including a surgical procedure and a percutaneoustechnique.

Such tubes may include an inner cannula, such as a reusable innercannula, or a disposable inner cannula. The inner cannula may bedisposed inside the tracheostomy tube and used as a conduit for liquidsor gas incoming and outgoing into the patient's lungs. The inner cannulamay be removed for cleaning and for disposal of secretions withoutdisturbing the placement of the tracheostomy tube. A connector istypically provided at an upper or proximal end where the tube exits thepatient airway, suitable for coupling the ventilator with the innercannula. In one embodiment, the inner cannula may be removed, cleaned,and reused. In another embodiment, the inner cannula may be disposable,and a new inner cannula may then be positioned inside of the trachealtube. By enabling the cleaning and/or replacement of the inner cannula,a ventilation circuit may be kept clean and free of secretions.

Standard connectors have been developed to allow the tracheal tube tothen be fluidly coupled to artificial ventilation equipment to supplythe desired air or gas mixture to the patient, and to evacuate gasesfrom the lungs. One difficulty that arises in the use of tracheal tubes,and tracheostomy tubes in particular, is in the connection of the tubeto the ventilation equipment. For example, an inner cannula may not beinstalled, or may be installed improperly. This may lead to difficultieswith ventilation when a connection is made to ventilation equipment.

There is a need, therefore, for improved tracheal tubes, andparticularly for improved tracheostomy tubes. It would be desirable toprovide a tube that allows for ease of placement and connection of theinner cannula during ventilation.

BRIEF DESCRIPTION

This disclosure provides a novel tracheal tube designed to respond tosuch needs with a low insertion force and a high retention force. Thetracheal tube may be a tube with a separate inner cannula and outercannula. The outer cannula connector includes a relatively rigid portion(e.g., a standard 15 mm connector) that couples to upstream medicaltubing and/or devices. The outer cannula connector also includes acompressible portion that compresses to change the shape and/or diameterof the interior of the outer cannula connector. This in turn facilitatesrelease of an inserted inner cannula. In certain embodiments, the innercannula may include features that mate with complementary features onthe compressible portion. Compression may release the mating features.In contrast to other types of inner cannula connectors, such as threadedor snap-on connectors, the disclosed embodiments may provide innercannulas that may be inserted and released with low insertion forces. Inaddition, the inner cannulas may also resist axial or rotationaldisplacement relative to the outer cannula.

Thus, in accordance with a first aspect, a tracheal tube assemblyincludes an outer cannula configured to be positioned in a patientairway. The assembly further includes a flange member secured about theouter cannula and an outer cannula connector coupled to a proximal endof the outer cannula wherein the outer cannula connector comprises aproximal rigid portion and a distal compressible portion whereincompression of the distal compressible portion results in a larger innerdiameter of the compressible portion in at least one dimension. Theassembly further includes an inner cannula configured to be disposedinside the outer cannula such that the inner cannula and the outercannula are coaxial an inner cannula connector coupled to the innercannula and configured to be disposed in the outer cannula connector.

In accordance with another aspect, a tracheal tube outer cannulaincludes a conduit configured to receive an inner cannula; a connectorcoupled to the conduit, the connector comprising: a compressible portiondisposed between a proximal portion of the connector and the conduit,wherein the compressible portion is configured to be deformed whencompressed along a first axis such that a first diameter along the firstaxis decreases and a second diameter along a second axis increasesrelative to an uncompressed configuration.

Also disclosed herein is a tracheal tube assembly that includes an outercannula configured to be positioned in a patient airway; a flange membersecured about the outer cannula; an outer cannula connector coupled to aproximal end of the outer cannula, wherein the outer cannula connectorcomprises a compressible portion disposed between the flange member anda rigid proximal portion, wherein the compressible portion is configuredto be in an uncompressed configuration when unbiased and a compressedconfiguration when force is applied; an inner cannula configured to bedisposed inside the outer cannula such that the inner cannula and theouter cannula are coaxial; and an inner cannula connector coupled to theinner cannula and configured to be disposed in the outer cannulaconnector.

BRIEF DESCRIPTION OF THE DRAWINGS

Various aspects of the disclosed techniques may become apparent uponreading the following detailed description and upon reference to thedrawings in which:

FIG. 1 is a perspective view of a tracheal tube with a compressibleinner cannula connector inserted into a patient in accordance withembodiments of the present disclosure;

FIG. 2 is a perspective view of the tracheal tube of FIG. 1;

FIG. 3 is a perspective view of the inner cannula outside of the outercannula of the tracheal tube of FIG. 1;

FIG. 4A is a cross-sectional of a compressible portion of the trachealtube of FIG. 3 in an uncompressed configuration;

FIG. 4B shows the compressible portion of FIG. 4A in the compressedconfiguration;

FIG. 5A is a cross-sectional of an alternative embodiment of acompressible portion of the tracheal tube of FIG. 3 in an uncompressedconfiguration;

FIG. 5B shows the compressible portion of FIG. 5A in the compressedconfiguration;

FIG. 6A is a cross-sectional of an alternative embodiment of acompressible portion of the tracheal tube of FIG. 3 in an uncompressedconfiguration with an inserted inner cannula;

FIG. 6B shows the compressible portion of FIG. 6A in the compressedconfiguration;

FIG. 7 is a cross-sectional view of the inner cannula connector of thetracheal tube of FIG. 3; and

FIG. 8 is an exploded view of the tracheal tube of FIG. 1.

DETAILED DESCRIPTION OF SPECIFIC EMBODIMENTS

One or more specific embodiments of the present techniques will bedescribed below. In an effort to provide a concise description of theseembodiments, not all features of an actual implementation are describedin the specification. It should be appreciated that in the developmentof any such actual implementation, as in any engineering or designproject, numerous implementation-specific decisions must be made toachieve the developers' specific goals, such as compliance withsystem-related and business-related constraints, which may vary from oneimplementation to another. Moreover, it should be appreciated that sucha development effort might be complex and time consuming, but wouldnevertheless be a routine undertaking of design, fabrication, andmanufacture for those of ordinary skill having the benefit of thisdisclosure.

The tracheal tubes as provided herein are disposable rather thanreusable, capable of providing differential mechanical ventilation toeither or both lungs, and capable of supporting all other functions ofstandard tracheal tubes (e.g. sealing, positive pressure generation,suctioning, irrigation, drug instillation, etc). The tracheal tubes canbe used in conjunction with all acceptable auxiliary airway devices suchas (e.g. heat and humidity conservers, mechanical ventilators,humidifiers, closed suction systems, scavengers, capnometers, oxygenanalyzers, mass spectrometers, PEEP/CPAP devices, etc). Furthermore,although the embodiments of the present disclosure illustrated anddescribed herein are discussed in the context of tracheal tubes such astracheostomy tubes, it should be noted that presently contemplatedembodiments may include a tracheal tube assembly including acompressible release grip used in conjunction with other types of airwaydevices. For example, the disclosed embodiments may be used inconjunction with a single-lumen tube, an endotracheal tube, adouble-lumen tube (e.g., a Broncho-Cath™ tube), a specialty tube, or anyother airway device with a main ventilation lumen. Indeed, any devicewith a ventilation lumen designed for use in an airway of a patient mayinclude an inner cannula with a compressible end as provided. As usedherein, the term “tracheal tube” may include an endotracheal tube, atracheostomy tube, a double-lumen tube, a bronchoblocking tube, aspecialty tube, or any other airway device.

Turning now to the drawings, FIG. 1 is a perspective view of anexemplary tracheal tube 10 placed in a patient's airway in accordancewith aspects of the present disclosure. The tracheal tube assembly 10represented in the figures is a tracheostomy tube, although aspects ofthis disclosure could be applied to other tracheal tube structures, suchas endotracheal tubes. The application to a tracheostomy tube is apt,however, insomuch as such tubes tend to be worn for longer periods oftime and, thus, may include a removable and/or disposable inner cannuladisposed inside of an outer cannula 12, which is useful in maintaining aclean ventilation circuit.

The tracheal tube 10 includes an outer cannula 12 that defines aventilation lumen and that facilitates the transfer of gases to and fromthe lungs. The tracheal tube 10 includes an inflatable cuff 16 disposedon the outer cannula 12. However, certain embodiments of the disclosuremay be used in conjunction with cuffless tubes. A proximal end of thetracheal tube 12 may connect to upstream airway devices (e.g., aventilator) via the appropriate medical tubing and/or connectors. Inembodiments that include a cuff 16, a pilot balloon and inflation lineassembly 18 is coupled to the cuff 16.

The outer cannula 12 is illustrated extending both distally as well asproximally from a flange member 20. A pair of side wings of the flange20 extend laterally and serve to allow a strap or retaining member (notshown) to hold the tube assembly 10 in place on the patient. In oneembodiment, apertures formed in each side of the flange member 20 allowthe passage of such a retaining device. In many applications, the flangemember 20 may be taped or sutured in place as well. During intubation,the tracheal tube assembly 10 is placed through an opening formed in theneck and trachea of a patient and extending into the patient airway. Incertain embodiments, the tracheal tube assembly 10 is curved toaccommodate the curved tracheal passageway. For example, the outercannula 12 may be curved in an unbiased state (i.e., outside thepatient) such that an inner curve 22 is generally positioned on aventral side of the patient while the outer curve 24 is positioned onthe dorsal side of the patient when the tracheal tube assembly 10 isinserted in the patient. Further, while a distal portion of the outercannula 12 is inserted within the patient, a proximal portion of theouter cannula 12 forms an outer cannula connector 28. As providedherein, the outer cannula connector 28 includes a compressible portionthat may be compressed to facilitate insertion and/or removal of theinner cannula and, in an uncompressed configuration, forms a secureconnection.

FIG. 2 is a perspective view of the tracheal tube assembly 10 showing aninner cannula 30 inserted in the outer cannula 12 and forming aconnection with the outer cannula connector 28. A proximal end 34 of theinner cannula connector 36 is exposed (i.e., is not within the outercannula connector 28). The inner cannula 30 is generally coaxial withthe outer cannula 12 and is shaped to fit within the outer cannula 12 toform the gas conveying passageway to the patient. In this manner, theinner cannula 30 may be removed and replaced while the outer cannula 12is retained. This reduces stress on the stoma while permitting cleaningof the passageway. The outer cannula connector 28 includes acompressible portion 40. A biasing force (shown by arrows 42) compressesthe compressible portion 40 to release the grip and/or connectionbetween the inner cannula 30 and the outer cannula 12.

The outer cannula connector 28 also includes a proximal coupler 46 thatforms a connection with upstream medical devices. The outer cannulaconnector 28 may be formed in accordance with industry standards topermit and facilitate connection to ventilating equipment (not shown).By way of example, the outer cannula connector 28 is a 15 mm connector,although other sizes and connector styles may be used. Additionally, thetracheal tube assembly 10 may be connected to other medical devices,such as a suction device, a T-junction, a medicine delivery system, andso forth. Indeed, the outer cannula connector 28 may enable theattachment of one or more medical devices to the tracheal tube assembly10. To accommodate such a connection, the inner cannula 30 and itsproximal end 34 may be formed such that, when inserted, the innercannula 30 does not interfere with coupling via the outer cannulaconnector 28. To that end, in particular embodiments, the widestdiameter of the inner cannula 30, including any protruding portions, issmaller than the widest outer diameter (e.g., 15 mm) of the proximalcoupler 46. Because the inner cannula 30 is configured to be insertedand/or removed by an operator, the proximal end 34 may protrude from theouter cannula connector 28 to allow the inner cannula 30 to bemanipulated. For example, the proximal end 34 of the inner cannula 30may be positioned so that the operator grips the proximal end 34 duringinsertion or removal.

The compressible portion 40, which is located away from a proximal end48 of the inner cannula connector 28, may extend radially away from anexterior surface 49 of the proximal coupler 46. Accordingly, thecompressible region 40 may form a shelf 52 that couples the compressibleregion 40 to the proximal coupler 46. In one embodiment, an outercircumference 53 of the proximal coupler 46 may fit entirely within anouter circumference 54 of the compressible portion 40. In this manner,the relatively larger compressible portion 40 forms a slightly largerpassageway with room for compression in at least one direction (e.g.,along arrows 42).

In operation, the inner cannula 30 may be manually inserted into theouter cannula 12. As shown in FIG. 3, the inner cannula 30 may beinserted by pushing the distal end 56 through the proximal end 34 of theouter cannula 12, e.g., in the direction of arrow 58. The insertion iscomplete when the distal end 56 is generally located at or near thedistal end 58 of the outer cannula 12. In certain embodiments, thedistal end 56 of the inner cannula 30 terminates short of the distal end58 of the outer cannula and is disposed entirely within the outercannula. When the inner cannula 30 is inserted, the compressible endregion 32 is disposed at least in part within the outer cannulaconnector 28. In embodiments in which the outer cannula forms a curve,such as a Magill curve, the inner cannula 30 may also be curved in acomplementary fashion. Accordingly, the insertion may be directionalsuch that proper insertion involves an inner curve 60 of the innercannula 30 located proximate to or corresponding with the inner curve 22of the outer cannula 12 (which in turn corresponds to a ventral side ofthe patient when inserted). Similarly, the outer curve 62 of the innercannula 30 will be located proximate to the outer curve 24 of the outercannula 12 (which in turn corresponds to a dorsal side of the patientwhen inserted). The positioning of the inner cannula 30 in the outercannula 12 may be facilitated by operator technique and, in particularembodiments, with the aid of markings, instructions, or other visualindicators.

The inner cannula 30 forms a conduit from which liquids or gases,including medications, may enter through the proximal end 34. Both theinner cannula 30 and the outer cannula 12 have dimensions selected tofit easily through the stoma. In practice, a range of such tubes may beprovided to accommodate the different contours and sizes of patients andpatient airways. Such tube families may include tubes designed forneonatal and pediatric patients as well as for adults. By way of exampleonly, the outer cannula 12 of the tube 10 may range from 4 mm to 16 mm.The inner cannula 30 may be sized to correspond with an appropriateouter cannula 12. The outer cannula 12 and the inner cannula 30 may becharacterized by their inner diameters (referring to the diameter of theinterior of the passageway) or their outer diameters (referring to thediameter as measured from the exterior outside wall to exterior outsidewall).

Because the inner cannula 30 fits within the outer cannula 12, the outercannula 12 features a larger inner diameter 70 relative to an outerdiameter 74 of the inserted portion 76 of the inner cannula 30. Theouter diameter 74 of the inner cannula 30 may be selected to allowsufficient air flow while also fitting comfortably within the outercannula 12 and allowing for appropriate insertion force. The innerdiameter of the outer cannula 30 is less than the outer diameter 74 bythe thickness of the walls of the inner cannula 30. For example, aninner cannula 30 sized to 6.5 mm may have an outer diameter 74 of about6.5 mm and an inner diameter of about 5.5 mm. In such an embodiment, theinner cannula walls are about 1 mm thick in the inserted portion of theinner cannula 30 (e.g., in portions distal of the compressible endregion 32). Similarly, a 10 mm inner cannula 30 may have an innerdiameter of about 9 mm. Accordingly, tubes sized to 6.5 mm, 7.0 mm, 7.5mm, 8.0 mm, 8.5 mm, 9.0, or 10 mm may feature smaller inner diametersthat define the airflow passage.

Further, the inner diameter 82 at the proximal end 44 of the outercannula 12 is typically larger than the inner diameter 70 and isselected to couple to appropriate tubing. That is, the outer cannula 12is narrower in the inserted portion and is wider at the connector. Theinner cannula connector 36 also has a larger outer diameter 84 relativeto the inserted portion 76. In certain embodiments, the inner cannulaconnector 36 may flare or taper outwards gradually such that thediameter increases gradually, with the largest diameter 84 at theproximal end 34. In other embodiment, the inner cannula connector 36 32may include a generally barrel-shaped region with an outer diameter 84.

An operator may apply a biasing force (see arrow 42) to opposing sidesof the compressible portion 40 during insertion of removal of the innercannula 30. For example, an insertion force along arrow 58 may beaccompanied by a simultaneous compression of the compressible portion40. In certain embodiments, as the distal end 56 passes through thecompressible portion 40, the biasing force is along a plane generallyorthogonal to the direction of insertion. While the depicted embodimentshows compression along the lateral plane (i.e., relative to aventral-dorsal plane), it should be understood that the compressionforce may be applied at other points about the compressible portion 40.

FIG. 4A is a cross-section of the outer cannula connector 28 showing thecompressible portion 40 in an uncompressed configuration. In oneembodiment, the uncompressed configuration is a default or unbiasedconfiguration. The compressible portion 40 may form an annular shape,including a circle or elliptical shape, when uncompressed. In thedepicted embodiment, both the exterior circumference 96 and the interiorpassage 98 are generally circular. It certain embodiments, thecross-sectional shape formed by the exterior circumference 96 may bedifferent than the cross-sectional shape formed by the walls 97 ofinterior passage 98 and may depend on the shape and/or thickness of thewalls 97. For example, the exterior circumference 96 of the compressibleportion 40 may be generally elliptical while the interior passage 98 maybe generally circular. The diameter 100 of the interior passage 98 inthe uncompressed configuration may be selected to conform to the desiredinserted portion 76 of the inner cannula 30 (see FIG. 3). That is, thediameter 100 may be slightly larger than the corresponding inner cannulaouter diameter 74.

FIG. 4B shows the compressible portion 40 after application of a biasingforce along arrows 42. When force is, the sides 90 a and 90 b of thecompressible portion 40 move towards one another as the compressibleportion 40 assumes the compressed configuration. For example, anapplication of 5N of force or less may be applied to achieve sufficientcompression to insert the inner cannula 30. The biasing force results indeformation of the compressible portion 40 and a change in thecross-sectional shape formed by both the exterior circumference 96 andthe interior passage 98. As depicted, both the exterior circumference 96and the interior passage 98 are flattened to be more elliptical and lesscircular. Further, rather than a single diameter 100, the interiorpassage 98 may be characterized by a minor diameter 102 and a majordiameter 104. The relationship between the uncompressed diameter 100 andthe major diameter 104 and minor diameter 102 of the compressedconfiguration may be determined by the materials from which thecompressible portion 40 is formed. That is, the spring force of thematerial may influence the amount of deformation. In addition, thecoupling between the compressible portion 40 and the adjacent portionsof the outer cannula connector 28 may also influence the amount ofdeformation. For example, a compressible portion 40 that includes acompressible ring not directly or flexibly coupled to the outer cannulaconnector 28 may be characterized by the ability deform equally at anypoint along the ring. Such a structure may have more degrees of freedomand may compress differently than a compressible portion that includes acompressible ring that is directly coupled to one or more adjacent rigidelements at certain points along the ring. For such a structure,compression may resemble flattening in one direction. Accordingly,although the resulting compressed structure may be generally elliptical,the ellipse may be irregular.

Further, deformation of the compressible portion 40 may occur with orwithout an inserted inner cannula 30. In embodiments in which the innercannula 30 is inserted, abutment of the interior surface 106 of thecompressible portion against the inner cannula may halt furthercompression by an operator. Accordingly, during insertion, the operatormay adjust the level of compression according to feel and judgment. Thatis, as the proximal end 54 enters the compressible portion 40, anydifficultly in inserting the inner cannula 30 may be alleviated bydecreasing the amount of biasing force applied until the appropriateinsertion force is achieved. In addition, the dimensions of the interiorpassage 98 and the outer diameter of the inner cannula 30 may form partof the coupling. For example, the inner cannula 30 may be sized to forma compression fit with the inner cannula connector 28 when inserted andthe compressible portion 40 is uncompressed.

FIG. 5A is view of a cross-section of an alternate embodiment of acompressible portion 40 having a generally elliptical shape and defininga generally elliptical passageway 98 in an uncompressed configuration.The compressible portion 40 features a minor diameter 110 along a firstaxis 112 and a major diameter 114 along a second axis. As shown in FIG.5B, upon compression along the axis 116 of the major diameter 114, shownby arrows 42), the sides 90 a and 90 b move towards each other and thediameter 112 between them decreases relative to the uncompresseddiameter 114 along the same axis. In the depicted embodiment, theellipse becomes more circular when compressed in the direction shown. Inaddition, the diameter 120 along the first axis 112 increases relativeto the uncompressed diameter 110 along the same axis. In certainembodiment, the diameter 122 is between 90-95%, between 80-90%, or atleast 70% of the uncompressed diameter 114. Similarly, the diameter 112is between 90-95%, between 80-90%, or at least 70% of the diameter 120.

FIG. 6A illustrates a cross-section of a compressible portion 40 with aninserted inner cannula 30. In particular embodiments, the compressibleportion 40 may include mating features on the interior wall 106 thatcouple to complementary features on the exterior surface 144 of theinner cannula 30. Such mating features may form part of a release gripformed by the compressible portion 40. Further, the mating features mayprevent rotational movement of the inner cannula 30 relative to theouter cannula connector 28. In addition, the mating features may provideadditional alignment to facilitate correct alignment of the curve of theinner cannula 30 with the curve of the outer cannula 12 (see FIG. 3). Itshould be understood that the positions of the mating features may beexchanged. That is, in certain embodiments, one or more of the disclosedprotrusions may be exchanged with recesses and vice versa. In addition,the inner cannula 30 and/or the compressible portion 40 may includecombinations of recesses and protrusions. As depicted, the matingfeatures may be protrusions, such as one or more protrusions 150 formedon the exterior surface 144 of the inner cannula 30 and configured tomate with recesses 152 on the compressible portion 40. The protrusion150 may be formed in any suitable shape or combination of shapes, such arounded bump, a ramp shape, a pyramid structure, etc. Further, thecompressible portion 40 and/or the inner cannula 30 may include anynumber of mating features positioned about a circumference. For example,the compressible portion 40 may include two recesses 152 that oppose oneanother. In specific embodiments, opposing recesses 152 may be spaced atpositions corresponding to dorsal and ventral sides of the patient,i.e., the inner curve 22 and the outer curve 24 of the outer cannula 12.In addition, the recesses may be spaced 90 degrees apart from a majoraxis in the uncompressed configuration. In another embodiment,respective protrusions 150 and/or recesses 152 may be provided as apartial ring with an arc having less than 45° of circumference of thecompressible end region 32. In another embodiment, the protrusion 150may form a complete ring about the circumference of the exterior surface144 of the inner cannula 30.

The size of the protrusions 150 may be selected to fit into thecorresponding recess 152 in the compressible portion 40 and may be lessthan a thickness of the wall of the compressible portion 40. In oneembodiment, the protrusion 150 may protrude less than about 1 mm, lessthan about 1.5 mm or less than about 2 mm from the exterior surface 144.In particular embodiments, the protrusions 122 protrude less than awidest exterior diameter 162 of the compressible portion 40 in anuncompressed configuration. Alternatively, the protrusion 150 may fitinto complementary windows formed in the compressible portion 40. Insuch embodiments, the protrusion 150 may be larger. In addition, theinner cannula 30 may feature regions of varying outer diameters thatform a slope that is sized at its widest point to fit a major interiordiameter 164 in the uncompressed configuration. The slope may be formedproximate to the protrusion 150 to facilitate insertion of therelatively larger protrusion 150 into the inner cannula connector 28. Inaddition, the major interior diameter 164 may be selected to leavelateral gaps 170 between the exterior surface 144 of the inner cannula30 and the

In operation, deformation or compression of the compressible portion 40along arrows 42 results in the recesses 152 moving away from theprotrusions 150 to allow the protrusions clearance with the interiorpassageway. This facilitates insertion and removal in the compressedconfiguration and retention in the uncompressed configuration.Accordingly, the size and shape of the interior passageway 98 may beselected so that the size of the lateral gaps 170 is sufficient to allowthe appropriate amount of deformation and clearance of the protrusions150 within the passageway 98. Further, in certain embodiments, theposition of the protrusions 150 and the lateral gaps 170 may beexchanged. In the illustrated embodiment, the operator biasing force isapplied laterally, which may be a relatively easy position for thepatient or caregiver to apply force to an inserted tracheal tubeassembly 10.

Further, it should be understood that the size and shape of thecompressible portion 40 relative to the other portions of the outercannula connector 28 may be selected to facilitate retention and/orsealing of the inner cannula 30 and the outer cannula connector 28. FIG.7 is a cross-sectional view of the inner cannula connector 28illustrating that the compressible portion 40 maintains an interiordiameter 180 slightly larger than the interior diameter along the restof the outer cannula connector 28 in the uncompressed configurationwhile maintaining contact with at least a portion of the inner cannulaconnector 40 at the illustrated points. In addition, the proximal end 34may also terminate in a lip 200. The relatively thicker lip 200 mayterminate in an abutment surface configured prevent further movement ofthe inner cannula 30 distally, which may assist in aligning the innercannula 30 within the outer cannula 12.

As noted, the proximal end 34 of the inner cannula 30 is positionedoutside of the outer cannula connector 28, which facilitates operatormanipulation of the inner cannula 30. The proximal end 34 may includeadditional gripping features, such as ribs, scallops, or nubs tofacilitate operator manipulation. Further, the inner cannula 30 may beformed form a material that is relatively rigid or compressible.

FIG. 8 is an exploded view of a tracheal tube assembly including aninner cannula, an outer cannula connector 28, a flange member 20, anouter cannula 12, and an inflatable cuff 16. In the depicted embodiment,the outer cannula connector includes a proximal coupler 46 that isadjacent to the compressible portion 40. The proximal coupler ismaterials that are less deformable or compressible that those formingthe compressible portion 40. In certain embodiments, the proximalcoupler 46 is manufactured from materials that are relatively rigid(i.e., not substantially deformed) when compression forces of 5N or lessare applied. The compressible portion 40 also includes a conformablecover component 250 and a ring component 252. In one embodiment, thering component 252 may be formed from a hard but flexible molded piece(e.g., via injection molding) while the cover component may be formedfrom a relatively softer TPE injection molding. In certain embodiments,the ring component may be a spring or may be a material with shapememory and may be formed from a variety of materials or combinations ofmaterials that provide the desired deformation properties underoperator-applied forces. For example, in certain embodiments, the ringcomponent 250 is constructed from metal or polymeric materials(polypropylene, ABS).

In one embodiment, the ring component 252 may be injection molded in anopen position as two semi-circles joined by a living hinge. Duringassembly, the ring component 252 is coupled via snap fit components 256to a hub 260 that extends from the flange 20, which also maintains thering component in the closed position. The hub 260 may include receivingfeatures for the snap fit features that maintain the ring component 252in the desired position. These receiving features may be sealed duringassembly to prevent leaks in the ventilation circuit. The covercomponent 250 provides a comfortable exterior surface for patientcomfort. In one embodiment, the cover component 250 is molded over thering component 252, which in turn may couple the compressible portion 40to the proximal coupler 46. The compressible portion 40 is coupled tothe distal portions of the outer cannula 12 via the hub 260. In anotherembodiment, rather than employing snap fit couplings, the compressibleportion may be coupled to both adjacent portions of the outer cannulaconnector via the overmolded cover component 250.

Components of the tube assembly 10 may be manufactured according tosuitable techniques. For example, the inner cannula and/or outer cannula12, including the outer cannula connector 28, may be molded, overmolded,two shot molded, computer numerical control (CNC) machined, milled, orotherwise formed into the desired shape. In one embodiment, a mold ormold form may be used to manufacture the inner cannula 30. In oneembodiment, the mold or other manufacturing technique may facilitate aspeckled outer surface of the inner cannula 30, which may facilitateinsertion. One or more components may be manufactured of materials suchas a polyethylene (e.g., low density polyethylene), polypropylene, PTFE,expandable PTFE, polyvinyl chloride (PVC), a PEBAX silicone, apolyurethane, thermoplastic elastomers, a polycarbonate plastic, asilicon, or an acrylonitrile butadiene styrene (ABS). In particularembodiments, the material of the inner cannula 30 may be selected to be60 Shore D. Further, the ring component 252 may be formed from materialsselected to be 70 Shore A while the cover component 250 may be formedfrom polyurethane selected to be 35-45 Shore A.

It is envisioned that the tracheal tube assembly 10 as provided hereinmay be provided as an assembly and/or as a kit. A kit may include apackaging that encloses an inner cannula 30 sized for an outer cannula12. The kit may also include a neck strap for retaining the trachealtube 10 in place. The kit may also include an obturator. Othercomponents of the kit may include a cap configured to be placed on aproximal end 34 while the obturator is in use and that may be part ofthe obturator. The tube assembly 10 components (e.g., outer cannula 12,flange member 20, outer cannula connector 28, cuff 16, and pilot balloonassembly 18) may be assembled prior to in situ assembly of the innercannula 30 into the outer cannula 12. Indeed, the user or clinician mayperform final assembly of the tracheal tube 10 by selecting a desiredinner cannula 30 from a selection of inner cannulas and then insertingthe inner cannula 30 into the outer cannula 12 prior to intubation. Thusassembled, the tracheal tube 10 may then be inserted into the patient'strachea.

While the disclosure may be susceptible to various modifications andalternative forms, specific embodiments have been shown by way ofexample in the drawings and have been described in detail herein.However, it should be understood that the embodiments provided hereinare not intended to be limited to the particular forms disclosed.Indeed, the disclosed embodiments may not only be applied to airwaydevices, but these techniques may also be utilized for connectionsbetween inner and outer conduits for other types of medical devices andmedical connective tubing. Rather, the various embodiments may cover allmodifications, equivalents, and alternatives falling within the spiritand scope of the disclosure as defined by the following appended claims.

What is claimed is:
 1. A tracheal tube assembly comprising: an outercannula configured to be positioned in a patient airway; a flange membersecured about the outer cannula; an outer cannula connector coupled to aproximal end of the outer cannula, wherein the outer cannula connectorcomprises a proximal rigid portion and a distal compressible portion,wherein compression of the distal compressible portion results in alarger inner diameter of the compressible portion in at least onedimension; an inner cannula configured to be disposed inside the outercannula such that the inner cannula and the outer cannula are coaxial;and an inner cannula connector coupled to the inner cannula andconfigured to be disposed in the outer cannula connector.
 2. Thetracheal tube assembly of claim 1, wherein the distal compressibleportion comprises one or more mating features disposed on an interiorsurface and configured to mate with one or more complementary featureson the inner cannula connector.
 3. The tracheal tube assembly of claim2, wherein the one or more mating features comprise a recessed annulus.4. The tracheal tube assembly of claim 3, wherein the one or morecomplementary features comprise a protruding ring.
 5. The tracheal tubeassembly of claim 3, wherein the one or more complementary featurescomprise opposing protrusions.
 6. The tracheal tube assembly of claim 2,wherein the one or more mating features comprise a protruding annulus.7. The tracheal tube assembly of claim 6, wherein the one or morecomplementary features comprise a plurality of protrusions.
 8. Thetracheal tube assembly of claim 2, wherein the one or more complementaryfeatures comprise a tapered region having a varying exterior diameter.9. The tracheal tube assembly of claim 1, wherein the distalcompressible portion comprises an ellipse having a minor axis thatextends from a ventral side to a dorsal side of the tracheal tubeassembly when the tracheal tube is inserted in the patient and a majoraxis that extends laterally.
 10. The tracheal tube assembly of claim 9,wherein the minor axis, from exterior surface to exterior surface, islarger than an exterior diameter of the proximal rigid portion.
 11. Thetracheal tube assembly of claim 1, wherein an exterior circumference ofthe distal compressible portion is larger than an exterior circumferenceof the proximal rigid portion.
 12. The tracheal tube assembly of claim1, wherein the distal compressible portion is adjacent to the rigidproximal portion.
 13. The tracheal tube assembly of claim 1, wherein theouter cannula connector comprises a distal rigid portion coupled to adistal end of the distal compressible portion and to the flange member.14. The tracheal tube assembly of claim 1, wherein the distalcompressible portion comprises a compressible annulus member covered bya resilient material.
 15. The tracheal tube assembly of claim 1, whereinthe distal compressible portion comprises a shape memory material. 16.The tracheal tube assembly of claim 1, wherein the distal compressibleportion is configured to assume a compressed configuration underpressure, wherein the compressed configuration comprises a decrease in afirst diameter along a first axis and an increase in a second diameteralong a second axis.
 17. A tracheal tube outer cannula comprising: aconduit configured to receive an inner cannula; a connector coupled tothe conduit, the connector comprising: a compressible portion disposedbetween a proximal portion of the connector and the conduit, wherein thecompressible portion is configured to be deformed when compressed alonga first axis such that a first diameter along the first axis decreasesand a second diameter along a second axis increases relative to anuncompressed configuration.
 18. The tracheal tube outer cannula of claim16, comprising one or more indicators disposed on an exterior of thecompressible portion and along the first axis
 19. A tracheal tubeassembly comprising: an outer cannula configured to be positioned in apatient airway; a flange member secured about the outer cannula; anouter cannula connector coupled to a proximal end of the outer cannula,wherein the outer cannula connector comprises a compressible portiondisposed between the flange member and a rigid proximal portion, whereinthe compressible portion is configured to be in an uncompressedconfiguration when unbiased and a compressed configuration when force isapplied; an inner cannula configured to be disposed inside the outercannula such that the inner cannula and the outer cannula are coaxial;and an inner cannula connector coupled to the inner cannula andconfigured to be disposed in the outer cannula connector.
 20. Thetracheal tube assembly of claim 19, wherein the uncompressedconfiguration and the compressed configuration both comprise ellipsesabout their respective outer circumferences.
 21. The tracheal tubeassembly of claim 20, wherein a major axis of the uncompressedconfiguration is orthogonal to a major axis of the compressedconfiguration.
 22. The tracheal tube assembly of claim 19, wherein asmallest inner diameter in the uncompressed configuration is less than asmallest inner diameter in the compressed configuration.
 23. Thetracheal tube assembly of claim 19, wherein the inner diameter of therigid portion is substantially the same under a biasing force thatreversibly compresses the compressible portion.
 24. The tracheal tubeassembly of claim 19, wherein the inner diameter of the rigid portionchanges less than 1% under a biasing force that reversibly compressesthe compressible portion.